During a videofluoroscopic swallow study, vallecular residue after swallow is most likely caused by which of the following?

During a videofluoroscopic swallow study, vallecular residue after swallow is most likely caused by which of the following?

• A. Reduced opening of the UES
• B. Reduced epiglottis inversion
• C. Nasal regurgitation
• D. A and B

Answer: (D)

Vallecular residue after a swallow signals incomplete clearance of the bolus from the pharynx and a less effective airway-protection mechanism. The epiglottis normally inverts to shield the airway and help direct material away from the laryngeal inlet. If epiglottic inversion is reduced, more bolus material remains in the vallecula rather than being efficiently cleared downward. In addition, the upper esophageal sphincter needs to open to allow the bolus to pass into the esophagus; when UES opening is reduced, clearance through the pharynx is hampered, allowing residue to linger in the vallecular region. Nasal regurgitation indicates velopharyngeal dysfunction and isn’t the mechanism behind vallecular residue. So both reduced epiglottic inversion and reduced UES opening contribute to vallecular residue.

Vallecular residue after a swallow signals incomplete clearance of the bolus from the pharynx and a less effective airway-protection mechanism. The epiglottis normally inverts to shield the airway and help direct material away from the laryngeal inlet. If epiglottic inversion is reduced, more bolus material remains in the vallecula rather than being efficiently cleared downward. In addition, the upper esophageal sphincter needs to open to allow the bolus to pass into the esophagus; when UES opening is reduced, clearance through the pharynx is hampered, allowing residue to linger in the vallecular region. Nasal regurgitation indicates velopharyngeal dysfunction and isn’t the mechanism behind vallecular residue. So both reduced epiglottic inversion and reduced UES opening contribute to vallecular residue.